Provider Demographics
NPI:1639447881
Name:WALKER, GAIL G (LVN)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:G
Last Name:WALKER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3818
Mailing Address - Country:US
Mailing Address - Phone:949-237-8661
Mailing Address - Fax:
Practice Address - Street 1:8281 45TH LN
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:IA
Practice Address - Zip Code:50061-5813
Practice Address - Country:US
Practice Address - Phone:515-402-6543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAREGISTRY#226991374U00000X
CA280367164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide